Friday, September 30, 2011

Private Insurers to Pool Data for Cost Analyses

Aetna, Humana, Kaiser Permanente, and the UnitedHealth Group plan to regularly supply information to a newly created nonprofit group, the Health Care Cost Institute, to help researchers begin to answer fundamental questions about why health care is so expensive, says a New York Times article.

The insurers will not have access to the aggregated pool of private data, and the data will not be accessible to the public. The new institute will provide claims information to qualified researchers seeking to analyze the data, and it will make public twice-a-year summaries that identify changes in health care prices and use of medical services, possibly in specific areas such as orthopedic claims. Highlighting certain trends, says the Times, could serve to put pressure on individual fields where prices seem abnormally high, or expose areas where demands for services have not been met.

The claims data, which will not include any identifying information about patients and will not specify the physician or hospital providing care, represents health care spending since 2000 and will be updated at least twice a year. The claims will not be made available for commercial use, partly because officials want to prevent their use by any insurer negotiating with hospitals and physicians.

The data could provide answers about the differing cost of hip replacements, or how commercial prices affect insurance premiums. The claims data will include the price, volume, and intensity of care being delivered to people with private coverage and will be compared with Medicare cost data, the article says.